Violence and abuse in the healthcare sector is on the rise, and dentistry is no exception. What makes the situation in Community Dental Services (CDS) particularly important and distinct is the nature of the patient group. CDS dentists often work closely with vulnerable patients, including many with special needs, which can create a complex and sometimes blurred line between what constitutes abuse or violence, and challenging patient behaviour.
This complexity makes it all the more crucial to develop clearer guidance and robust policies that genuinely protect dental teams. Moreover, CDS dentists typically have much closer and more frequent contact with their patients. This unique dynamic heightens the risk and impact of violent and abusive incidents. Those who dedicate themselves to caring for these vulnerable populations deserve to feel safe while doing so.
Incidents of violence and abuse affect the safety, wellbeing, and the morale of CDS dentists. Research from our Policy and Research team has revealed worrying levels of verbal abuse and physical violence against CDS dentists and highlighted its damaging repercussions. Our annual surveys also demonstrate similar trends. Among those surveyed, 45% reported experiencing physical violence, 73% encountered verbal abuse, and an overwhelming 96% dealt with demanding or aggressive behaviour.
This topic has been repeatedly raised by our members and via their elected members within our representative committees across all four nations. We have made it clear that this is not just about individual experiences; it affects the whole service, the teams who deliver care, and ultimately patient safety. Now is the time to act.
We listened to you
To build our understanding on what is happening at the ground level, we launched a survey earlier this year involving our England Community Dental Services Committee (ECDSC) members and network of CDS Accredited Representatives. The survey we conducted focused on current policies and best practice in place to reduce and prevent violence and abuse within the CDS. It also gathered some lived experiences of dental professionals that revealed the stark reality and human impact caused by these incidents.
Our findings
The survey painted two distinct pictures - the one within procedures set out by employers, and the other the reality on the ground that our frontline members face.
On paper, there were examples provided of best practice, using team huddles, following zero tolerance policies, warning markers on patient notes, training modules, physical changes to clinical layouts, and even the involvement of security teams. However, these measures and approaches varied markedly between trusts.
The real impact emerged in the stories shared by CDS dentists. They spoke of physical assaults, verbal abuse, racism, threats, and safeguarding concerns. Many dentists faced barriers in reporting due to unclear processes, a lack of faith that anything would change to ensure protection, administrative burdens, and the sheer lack of time due to ever rising workload pressures.
Deeper cultural issues were also highlighted, increasing normalisation of abuse, prioritising work over workforce wellbeing, and a trend of experiencing blurred lines when incidents involved patients with special needs. There was also a shared perception that management might not always act decisively, and it was evident that there were gaps in the structure which had to be addressed.
The toll these incidents took on the dentists was clear including loss of confidence, hesitation in clinical judgement, and burnout. In a service already facing recruitment and retention challenges, these consequences are deeply concerning.
What stood out most, however, was the strong appetite for change. It was clear that there is a need for stronger policies, clearer guidance, practical training, and leadership support that places staff safety alongside patient care as a priority. After all, if those delivering care do not feel safe, then the quality of care will inevitably suffer.
What next?
For us, this is about acknowledging the problem which is a critical first step within a long journey. More work lies ahead, and the current situation must not be allowed to continue.
We are now lobbying employers to implement stronger policies, ensure consistent good practice, close the gaps identified in the survey and tackle the abuse and violence within the CDS on a wider scale.
We know that the significant waiting lists to access CDS is a critical factor behind the frustration that is expressed by patients, their carers, and their families. Although this does not justify in any way the violence and abuse against CDS dentists and their colleagues, we are also campaigning for Governments in all four nations to deliver full transparency around the scale of unacceptably long waiting lists and set out substantive plans to address the backlogs. As more data comes on stream at the end of this year and the start of next year, we will provide further commentary and highlight the adverse impacts of these delays on patients.
As this project takes more shape and form, we will use our channels to share updates, progress, and resources - keeping the conversation active and striving to achieve meaningful change.